Provider Demographics
NPI:1336674373
Name:HILLCREST HEALTH
Entity Type:Organization
Organization Name:HILLCREST HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HOMECARE OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:O'DONNELL
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:402-599-9644
Mailing Address - Street 1:1820 HILLCREST DR STE A
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:68005-3636
Mailing Address - Country:US
Mailing Address - Phone:402-682-4808
Mailing Address - Fax:
Practice Address - Street 1:1820 HILLCREST DR STE A
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:NE
Practice Address - Zip Code:68005-3636
Practice Address - Country:US
Practice Address - Phone:402-682-4808
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-27
Last Update Date:2017-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE204251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health